In his ongoing Chicago Health Aging and Social RelationsStudy, funded by the National Institute on Aging, Cacioppoand colleagues have also linked loneliness with depressivesymptoms and an increase in blood pressure over time.

Other research indicates positive social connections might
accelerate disease recovery. In a study of 200 breast cancer
survivors, psychologist Lisa Jaremka, PhD, and colleagues
at the Ohio State University found that lonelier women
experienced more pain, depression and fatigue than those
who had stronger connections to friends and family. The
more disconnected women also had elevated levels of a
particular antibody associated with the herpes virus — a sign
of a weakened immune system (Psychoneuroendocrinology,
2013).

Particular genes may play a role in explaining why our
bodies are so attuned to our social lives, says psychologist
Steve Cole, PhD, at the University of California, Los Angeles.
In one study, he and colleagues including Cacioppo analyzed
the gene expression profiles of chronically lonely people and
found that genes expressed within two subtypes of white
blood cells are uniquely responsive to feelings of loneliness.
The cells — plasmacytoid dendritic cells and monocytes
— are associated with diseases such as atherosclerosis and
cancer, as well as “first line of defense” immune responses
(PNAS , 2011).

Cole says the most “biologically toxic” aspect of loneliness
is that it can make you feel chronically threatened, an
emotion that can wear on the immune system. “It’s really
that sense of unsafe threat, that vague worry, that’s probably
what’s actually kicking off the fight-or-flight stress responses
that affect the immune system most directly,” he says.

Friends in adulthood

As researchers work to better understand the link between
friendships and health, they’re also helping to answer a
question familiar to anyone who’s ever moved to a new city,
lost a spouse or otherwise found themselves feeling alone:
How do you make friends as an adult? Here’s what the
research suggests might work:

• Be a familiar face. The idea that familiarity breeds
attraction is long-established by research, and was again
supported in a 2011 study led by psychologist Harry Reis,
PhD, at the University of Rochester. In the first experiment,
same-sex strangers rated how much they liked one another
after having several structured conversations. In the other,
strangers chatted freely online. In both cases, the amount
(Journal of Personality and Social Psychology, 2011).

Rachel Bertsche, a writer in Chicago, witnessed thisphenomenon outside of the lab when she joined a weeklycomedy class a few years ago. At first, she thought herclassmates were strange. But she gradually changed her mind— and soon wound up joining the group for drinks afterclass. “Consistency is so important,” she says.

Fehr agrees. She says sticking to a simple routine —
whether it’s going to the same coffee shop at the same time
every day, joining a class like Bertsche or even just going to
the office mailroom when it’s most crowded — can help turn
strangers into friends.

Why psychologists need friendsFriends are important, no matter who you are.

But psychologists’ careers may depend on
friendship, says Brad Johnson, PhD, a professor
of psychology in the Department of Leadership,
Ethics and Law at the U.S. Naval Academy and
former chair of APA’s Ethics Committee.

“There’s lots of evidence that human beingsare generally not especially accurate when itcomes to any assessment of a character trait or askill,” he says. “Sadly, the same applies to health-care professionals — we are not very good at ac-curately assessing our own level of competence.”Johnson and others urge psychologists tocreate “competency communities” throughwhich they can engage in feedback from trustedfriends and colleagues. Such a network wascritical to Johnson, who turned to his clinicalpsychologist sister Shannon Johnson, PhD, aswell as colleagues Jeffrey Barnett, PsyD, andDouglas Haldeman, PhD, when he was beingtreated for a brain tumor. “ I really think that if Ihad been an isolated person in private practiceat that point, this really would have been moreproblematic,” says Johnson.

APA President Nadine Kaslow, PhD, of EmoryUniversity in Atlanta, says the friends andcolleagues in her “competence constellation”have supported her through good times and bad.“ I greatly value the strength of these bonds, thehonesty in these relationships and the diversity ofperspectives these colleagues offer,” she says.

To spur a culture change away from
independence and more toward mutual
trust and compassionate feedback, these
psychologists have recommended changes
to the APA Ethics Code that obligates
psychologists to look out for one another.